| NPI | 1235908567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 10023094) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 202005793) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 10023094) | |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2025-05-15 |